Professional accountability

Professional accountability for nurses

1. P rofessional A ccountability Presenter : Pratibha MSc.N 2 nd yr NINE, PGIMER

2. Content outline Profession : Its characteristics , characteristics of a professional nurse, criteria of a profession Accountability : Its meaning, definition, characteristics, line of accountability, framework & pillar of accountability Professional accountability : Its concept, definition, regulation in profession, regulatory bodies, function of regulatory bodies, elements of professional accountability, principles N ursing professional are accountable to, for ,& to whom, role of professional nurse Reason and ways to promote professional accountability

3. Profession A profession is a group of vocational, occupational and educational that requires specialized education and intellectual knowledge

4. Characteristic of a profession

5. General characteristics of a profession Autonomy Regulation Legitimacy Status Theoretical knowledge based skill Licensed practitioners Code of ethics and professional conduct

6. Characteristics of a professional nurse Personal characteristics Commitment Knowledgeable Technical skills Patient centeredness Communication skills Advocacy Emotionally strong

7. Characteristics of a professional nurse Cont.. Empathetic Critical thinking Interpersonal skills Problem solving skills

8. Criteria of a profession

9. Criteria of a profession Cont..

10. MEANING : Accountability involves assuring only the responsibility that are within one's scope of practice and not assuming responsibility for activities in which competencies has not been achieved Accountability involves admitting mistakes rather than blaming others and evaluating the outcomes of one's own actions

11. Accountability Cont.. Accountability includes a responsibility to the client to competent to render nursing services in accordance with standards of nursing practice and to adhere to the professional ethics code

12. Definitions Accountability is being responsible for one's actions and accepting the consequences of one's behaviour Accountability is not a vague feeling or an obscure concept. It is a clear obligation which must be manifested as a structured component of nursing practice, based on responsibility, authority and autonomy “It refers to the ability to answer for one's own actions, or it is the ability and willingness to assume responsibility for one's actions and to accept the consequences of one's behaviour”. Sullivan and Deekan

13. Definition Cont… American Nurses Association Code of Nurse defines, “accountability being answerable to someone for something one has done. It means providing an explanation to self, to the client, to the employing agency and to the nursing profession . Accountability can be defined in terms of either of these attributes but answerability for how one has promoted, protected and met the health needs of the client.

14. Characteristics of accountability

15. Lines of accountability

16. Domains of accountability DIMENSION OF ACCOUNTABILITY Sl. No. Dimension Description 1. To the client The client is no longer blindly submissive, he is more aware of his rights, therefore he should be a full partner in decisions and actions regarding his health

17. DIMENSION OF ACCOUNTABILITY Sl. No. Dimension Description 1. 2. To the client To the society The client has a right to receive the best possible quality in an equally knowledgeable manner through the application of sound judgment and appropriate values system. Nurse must know the importance of documenting their work and the progresses used in accomplishing goals Nursing is also accountable to society because profession has received society's authorization to practice by virtue a degree/diploma Nursing is also accountable to the society in guarding against ill-prepared worker being certified to give nursing care

18. DIMENSION OF ACCOUNTABILITY Sl. No. Dimension Description 3. 4. To the profession To self The profession of nursing has accountability towards itself in the performance of its duty to formulate its own policy and control its activities Its standard for licensure and certification. Nurses must be responsible for their own mental and physical health for assuming that she keeps all aspects for her life in balance Accountability to self also involves acknowledging her limitations and knowing when she is in need of further education in order to perform her role more fully and safely

19. DIMENSION OF ACCOUNTABILITY Sl. No. Dimension Description 5. To the employing agency /Institution The agency is accountable to the public for the care provided, therefore in turn, it has the right to expect the nurses to be accountable to agency

20. Framework of accountability

21. Four pillars of accountability

22. Professional accountability INTRODUCTION Professional accountability is at the heart of nursing practice It consists of an ethos in nursing that is based on promoting the welfare and wellbeing of patients through nursing care It allows nurses to work within a framework of practice and to follow principles of conduct that maintain the patient’s trust in the individual nurse and support for the nursing profession as a whole

23. Professional A ccountability Cont.. It drives to demonstrate professional accountability led to the creation of a body which is responsible for setting the standards of conduct and practice for nurses i.e the regulatory body for nurses and midwives Manifesting accountability in nursing practice provides the opportunity to evaluate nursing contribution within health care and is a means of clarifying the significance of nursing to society

24. Development of Nursing as an Accountable Profession Susan McGann traces the development of nursing as an accountable profession in 1919 Achieving professional status was a struggle for nurses With the passing of the Nurses’ Registration Acts, in 1919, nurses in Britain achieved the status of an accountable profession

25. Concept of professional accountability The concepts have two major attributes : - Answerability - Responsibility The modern concept of professional accountability, applied to nursing, assumes that the nurse is a member of a profession It depends on individual nurses being aware of their membership of a profession and accepting that status, with the rights and responsibilities that go with it

26. Concept of professional accountability Cont… With the passing of the Nurses Registration Act, in 1919, nurses in Britain achieved the status of an accountable profession, which meant that registered nurses were legally accountable for their work and can be struck off the register for unprofessional behaviour (Tilley and Watson 2004 ) .

27. Definition Professional accountability means that each individual nurse is answerable for her/his conduct and actions, and is responsible for the decisions she/he makes and how these affect the people to whom she/he owes a duty of care. The responsibility that this brings is to ensure that all reasonable actions are taken to ensure patient safety.

28. Definition cont... This implies that all nurses should be: Aware of the professional standards described in the regulatory body’s Code Confident that all decision-making is appropriately informed Able to justify all clinical actions or omissions Able to communicate appropriately and effectively with people, families, and other members of the healthcare team, whether in verbal, written, digital, or electronic formats

29. Conclusion : The quality or state of being accountable: an obligation or willingness to accept responsibility or to account for one’s actions , accountability is connected with “being answerable for one’s actions” , further explaining that “full accountability can only be held by the professional nurse who is comprehensively educated for the role. “it also suggests that someone takes his tasks and duties seriously, acts only after due deliberation, and considers himself answerable to others for the consequences of his actions” . Nurses are accountable for their omissions, lifelong learning, quality patient care, and for upholding standards of the profession.

30. Regulations in professional accountability Regulation is the mechanism by which the government can influence activity over : People Setting Products Services

31. Regulatory bodies : INTERNATIONAL AGENCIES

32. Regulatory body : international agencies cont... The  International Council of Nurses  ( ICN ) is a federation of more than 130 national nurses  associations It was founded in 1899 and was the first international organization for health care professionals The organization's goals are: T o bring nurses' organizations together in a worldwide body T o advance the socio-economic status of nurses and the profession of nursing worldwide T o influence global and domestic health policy

33. Regulatory bodies : National agencies Nurses are governed by code of Ethics adopted by : Indian nursing council State nursing council Trained nurses association of I ndia Rules of a particular hospital / Institution Therefore, an individual nurse is governed for her professional conduct at central, state, hospital/institution, existing laws and regulation, judicial rulings

34. Functions of nursing regulatory bodies Legal power to regulate profession

35. Elements of professional accountability

36. ELEMENTS OF PROFESSIONAL ACCOUNTABILITY Cont... The public holds nursing accountable for safe nursing care and proper judgment in the provision of nursing services The profession is held accountable by the public to ensure that only qualified individuals are granted the rights to practice and those who fail to uphold professional standards are denied the future rights to practice Professional accountability within nursing is adopted through the mechanisms by which nurses obtain the right to practice These mechanisms include rights and responsibilities, organizational accountability, individual accountability and students accountability.

37. ELEMENTS OF PROFESSIONAL ACCOUNTABILITY Cont... Rights and responsibilities : The nurse have responsibility to the client to be competent, to render nursing services in accordance with standards of nursing practice, and to follow to the profession’s ethical code Organizational Accountability: Organization is mean by which members of profession, such as nurses, join together to promote and protect the profession Legislative accountability for nurses to be recognizes as professional nursing must have legislation that clearly defines the role and scope of nursing practice

38. ELEMENTS OF PROFESSIONAL ACCOUNTABILITY Cont… Individual Accountability The nurses must understand the method by which the board of nursing adopts rule and regulations in their state of licensure so that they can be active participant in the development of such regulations Students Accountability For nursing students, accountability for competency being the first clinical day and continues throughout their career.

39. THE PRINCIPLES AGAINST WHICH TO EXERCISE ACCOUNTABILITY (UKCC, 1989)

40. THE PRINCIPLES AGAINST WHICH TO EXERCISE ACCOUNTABILITY (UKCC, 1989) Contd..

41. The nursing professional is accountable for:

42. Nursing personnel are accountable to

43. Nursing personnel are accountable for :

44. Nursing personnel are accountable for Contd..

45. Accountable to whom

46. Accountable to whom Cont...

47. A ccountable to whom Contd..

48. Conclusion : The most prevalent language found in the literature, ties accountability with responsibility for nursing actions. The second-most prevalent appearing eight times , associates accountability with being answerable to self and those who are influenced by one's actions. The other areas were described by the following language: nurses are accountable for lifelong learning, quality patient care, and for upholding standards of the profession

49. Role of professional accountability in nursing The registered nurse is accountable to the public for competent, safe and ethical practice. It helps: 1. Each registered nurse: Practices in accordance with: o The Registered Nurses Act, Regulation and by-laws o The standards for nursing practice o The code of ethics for registered nurses o Other relevant acts and legislation

50. Role of professional accountability in nursing Contd … Makes nurses responsible for own actions and decisions at all the times Recognizes and reports errors and takes all necessary action to prevent and minimize harm arising from an adverse event Takes action in situations where client safety and well-being is potentially or actually compromised Exercises reasonable judgment in practice

51. Role of professional accountability in nursing Contd … Seeks assistance appropriately and in a timely manner Supports policies and practices consistent with the college's standards for nursing practice and questions those in conflict with the standards Understands , promotes and complies with the values and beliefs in the code of ethics for registered nurses Contributes to a safe, supportive and professional practice environment

52. Conclusion: Primary healthcare nurses are involved directly with the public on a daily basis, hence there is a need to be cognizant of their public position, level of responsibility, and professional accountability. Professional nurses must not only strive to improve the quality of care; they must also be able to show that they are doing so. The community health nurses’ best legal defense is through the adoption of nursing process and documentation of their assessment, interventions, and evaluation of their clients

53. Conclusion : It is essential to set clear expectations for professional behavior with both faculty and residents and to describe problem behaviors as a deficiency in one or more competencies. Once a problem has been identified, the resident must be provided with a notice of deficiency and an opportunity to improve, with consequences for failing to address the deficiency.

54. Reasons for lack of professional accountability

55. Ways to maintain accountability

56. ways to maintain accountability Contd …

57. WAYS TO PROMOTE PROFESSIONAL ACCOUNTABILITY IN NURSING

58. WAYS TO PROMOTE PROFESSIONAL ACCOUNTABILITY IN NURSING Contd .

59. ACCOUNTABILITY PYRAMID TO PROMOTE PROFESSIONAL PERFORMANCE

60. CONCLUSION The person or position accountable for a task is responsible for insuring that it is completed on-time and in a manner which meets all expectations for it Accountability must never be used as a device for placing blame or designating a scapegoat Developing accountability does not mean relinquishing accountability on management's part However , as the group matures, members expect to be held more accountable for their own results

61. References Clement I. Textbook on professional trends and adjustments in nursing. 1 st edition. Jaypee Brothers Medical Publishers ; New Delhi : 2016. Pp 116-17 Basavanthapa B T . Nursing administration. 3 rd edition . Jaypee Brothers Medical Publishers; New Delhi: 2014 . pp 88-89 Rawat HC. Brar NK. Textbook of Advanced Nursing Practice. 1 st edition. Jaypee Brothers Medical Publishers. New Delhi.2014 . pp 13-16 Krautscheid LC. Defining professional nursing accountability: a literature review. Journal of Professional Nursing. 2014 Jan 1;30(1): 43-7

62. References Basvanthapa BT. Nursing administration. 2 nd edition . Jaypee Brothers Medical Publishers : New Delhi;2014. pp 664-74. Basvanthapa BT. Nursing education, 1st edition 2003, Jaypee Brothers Medical Publishers,  New Delhi,  p 77-9. Chitty KK. Professional Nursing. Elsevier,  4th edition, p 31, 63, 197, 579. Loretta EH. Teaching and learning in school of nursing, 3rd edition 2005, Konark Publishers.  p 187-90. Perry P. Fundamentals of Nursing, Elsevier,  7th edition, p 3-4. Suzanne SC, Brenda BG. Medical Surgical Nursing, Lippioncott . Jaypee Brothers Medical Publishers,  New Delhi,  10th edition, 2004; Volume-1, p 125-41. Www.Currentnursing.Com Www.Indiannursing.Com